22047_University Place Mall_DC680002_20190730_IA and SG Report

AECOM AECOM Technical Services of North Carolina, Inc. 919.461.1100 tel
1600 Perimeter Park Drive, Suite 400 919.461.1415 fax
Morrisville, NC 27560
July 30, 2019
North Carolina Department of Environmental Quality
Division of Waste Management — DSCA Program
1646 Mail Service Center
Raleigh, NC 27699
Att: Mr. Mike Cunningham
DSCA Project Manager
Re: June 2019 - Indoor Air and Soil Gas Sampling Report
American Dry Cleaners DSCA Site ID #DC680002
201 South Estes Drive, Chapel Hill, Orange County, North Carolina
Dear Mr. Cunningham:
AECOM Technical Services of North Carolina, Inc. (includes legacy URS and legacy AECOM herein
referred to as AECOM) is pleased to provide the attached Indoor Air and Soil Gas Sampling Report for
the American Dry Cleaners (#DC680002) site located at 201 South Estes Drive, Chapel Hill, North
Carolina. This report includes documentation pertaining to the indoor air and soil gas sampling activities
that were completed at the site in June 2019. The activities documented herein were completed in
accordance with State Lead Authorization for Work (SLAW) 028, as approved on February 28, 2019.
Due to the potential risk of vapor intrusion from tetrachloroethene (PCE) contaminated groundwater to
affect indoor air quality at the western portion of the Olin T. Binkley Church, periodic monitoring of soil
gas and indoor air quality was implemented in June 2017. This included the installation and sampling of
two permanent soil gas sampling points (SV-5 and SV-6) at the locations shown on Attachment 14.
Comprehensive information specific to the installation and initial sampling of soil gas sampling points
SV-5 and SV-6 in December 2016 is on file in the Groundwater and Vapor Monitoring Report, dated
January 18, 2018.
Pursuant to SLAW 028, AECOM replaced soil gas sampling point SV-6 with SV-6r as the intake to soil
gas sampling point SV-6 had become flooded. . Soil gas sampling points SV-5 and SV-6r were sampled
on June 14, 2019. The soil gas samples collected from SV-5 and SV-6r were analyzed for five DSCA
contaminants of concern: PCE, trichloroethene (TCE), cis-1,2-dichloroethene (DCE), trans-1,2-DCE, and
vinyl chloride using EPA Method TO-15 LL. Sampling results and locations are shown on Attachment
14. A summary of the soil gas quality results, as entered into DSCA risk calculators, is provided as
follows:
SV-5 (6/14/19) — non-residential worker
o Acceptable cumulative carcinogenic risk between 1E-04 and 1E-05 (8.0E-05); and,
o Unacceptable hazard index is greater than 1 (26).
SV-5 (6/14/19) - resident
o Unacceptable cumulative carcinogenic risk between 1E-02 and 1E-03 (1.4E-03); and,
o Unacceptable hazard index is greater than 1 (330).

A=COM
Mr. Mike Cunningham
American Dry Cleaners — DC680002
July 30, 2019
Page 2 of 3
SV-6r (6/14/19) — non-residential worker
o Acceptable cumulative carcinogenic risk between 1E-05 and 1 E-06 (7.1E-06); and,
o Unacceptable hazard index is greater than 1 (2.2).
SV-6r (6/14/19) - resident
o Unacceptable cumulative carcinogenic risk between 1E-03 and 1E-04 (1.2E-04); and,
o Unacceptable hazard index is greater than 1 (28).
Based on a review of soil gas quality data generated to date, concentrations of PCE in soil gas collected
from SV-5 have increased from 75,800 micrograms per liter (µg/m3) to a high of 140,000 µg/m3 in June
2018 and decreased to 93,000 µg/m3 in June 2019. TCE concentrations have ranged from 24,900 µg/m3
in June 2017 to a high of 40,000 µg/m3 in June 2018 then decreased to 18,000 µg/m3 in June 2019. Due
to water in the tubing during the June and December 2018 sampling events, limited data are available for
SV-6. Soil gas sampling point SV-6r was installed adjacent to SV-6 during the June 2019 sampling
event; therefore, no trend data is available.
As part of continued evaluation of potential vapor intrusion to affect indoor air quality in the preschool
classrooms located at the Olin T. Binkley Church, two indoor air samples (IA-2 and IA-3) were collected
concurrent with the soil gas samples in June 2019. Each indoor air sample was collected using a passive
Radiello sampler deployed for a period of 7 days from within two of the preschool classrooms located at
the Olin T. Binkley Church. Sampling results and locations are shown on Attachment 14. A summary of
the indoor air quality results, as entered into DSCA risk calculators, is provided as follows:
• IA-2 (6/7/19 - 6/14/19) — non-residential worker
o Acceptable cumulative carcinogenic risk less than 1E-06 (9.5E-07); and,
o Acceptable hazard index is less than 1 (0.28).
• IA-2 (6/7/19 - 6/14/19) - resident
o Acceptable cumulative carcinogenic risk between 1E-05 and 1E-06 (4.8E-06); and
o Unacceptable hazard index is greater than 1 (1.2).
• IA-3 (6/7/19 - 6/14/19) - non-residential worker
o Acceptable cumulative carcinogenic risk less than 1E-06 (6.8E-07); and
o Acceptable cumulative hazard index is less than 1 (0.18).
• IA-3 (6/7/19 - 6/14/19) - resident
o Acceptable cumulative carcinogenic risk between 1E-05 and 1E-06 (3.0E-06); and
o Acceptable cumulative hazard index is less than 1 (0.77)
As documented above, indoor air contaminant concentrations at indoor air sample IA-2 present an
acceptable cumulative carcinogenic risk and unacceptable risk for hazard index for residential exposure.
As previously reported in Indoor Air, Soil Gas, and Groundwater Sampling Report, dated March 7, 2019,
indoor air samples collected at sample locations IA-2 and IA-3 in December 2018 also indicated an
exceedance of residential risk specific to hazard index. Additional indoor air sampling events were
completed in January 2019 and February 2019 to determine if indoor air concentrations remained above
acceptable risk levels. Both confirmatory sampling events indicated indoor air concentrations of PCE and
TCE had slightly decreased to within calculated acceptable risk levels for residential use.
The work was done in accordance with AECOM Contract N16004, dated January 3, 2017, and in
accordance with the scope and estimates provided in the approved SLAW028. If you have any questions
or require additional information, please do not hesitate to call either Rob MacWilliams at 704-499-4839
or Nick Shore at 919-461-1485.

A=COM
Mr. Mike Cunningham
American Dry Cleaners — DC680002
July 30, 2019
Page 3 of 3
Sincerely,
AECOM TECHNICAL SERVICES OF NORTH CAROLINA, INC.
Nick Shore, PG
Project Manager
Enclosures
Robert H. MacWilliams, PG
Program Manager

ANALYTICAL DATA TABLES

Analytical Data Tables
for
North Carolina Dry -Cleaning Solvent Cleanup Act Program
Facility Name:
American Dry Cleaners
201 South Estes Drive, Chapel Hill, Orange County
DSCA ID No.:
DC680002
Submittal Date:
July 2019
Prepared By:
AECOM Technical Services of North Carolina, Inc.
1600 Perimeter Park Drive, Suite 400, Morrisville, North Carolina

Table of Contents
DSCA ID No.:
DC680002
Table/
Att. No.
Check box
Description if included
Tables
Table 1
Site Chronology
0
Table 2
Analytical Data for Soil
❑
Table 3
Analytical Data for Sub -slab Gas
❑
Table 4
Analytical Data for Soil Gas
0
Table 5
Analytical Data for Indoor and Outdoor Air
0
Table 6
Monitoring Well Construction Data
❑
Table 7
Groundwater Elevation Data
❑
Table 8
Analytical Data for Groundwater
❑
Table 9
Analytical Data for Surface Water
❑
Table 10
Water Well(s) Survey Data
❑
Table 11
Analytical Data for Water Supply Well(s)
❑
Table 12
Analytical Data for Natural Attenuation Parameters
❑
Attachments
Att. 1
Site map showing location(s) of soil boring(s).
❑
Att2
Soil contaminant concentration maps showing the concentration at each sampling
point.
El
Att. 3
Soil isoconcentration maps.
❑
Att. 4
Site map showing location(s) of monitoring well(s).
❑
Att. 5
Well completion diagrams and records of construction submitted to state.
❑
Att. 6
Groundwater gradient map for each sampling event.
❑
Att. 7
PCE concentration map showing the concentration at each sampling point and
isoconcentration map. However, if there are significant plumes for other dry-
cleaning contaminants, contaminant concentration maps for each chemical of
concern should be included.
❑
Att. 8
Groundwater concentration trend plots.
❑
Att. 9
Map showing location(s) of surface water sample(s) (if applicable).
❑
Att. 10
Surface water concentration map showing the concentration at each sampling
point (if applicable).
El
Att. 11
USGS Quad map with plotted water well location(s) within the 1,500 foot and 0.5
mile radii of the site (if applicable).
❑
Att. 12
Site map showing location(s) of monitoring well(s) for natural attenuation parametc
❑
Att. 13
Site map showing location(s) of indoor air, outdoor air, or soil gas samples.
❑
Att. 14
Air and soil gas concentration map showing the concentration at each sampling point.
Att.15
Signed laboratory analytical reports including chain -of custody and quality
assurance/quality control (QA/QC) documentation (only if not previously
submitted).
Att. 16
DSCA Program Risk Calculators
17
Att. 17
Indoor Air Building Survey Form
0
Att. 18
❑
Att. 19
❑
Att. 20
❑
Att. 21
❑
Note:
1. All maps must include a bar scale, north arrow, site name, DSCA ID No., and date.

Table 1: Site Chronology
DSCA ID No.: DC680002
Chronology of Events
Date
Instructions: Brief description of all significant events that have occurred since a problem was
suspected at the facility. Commence with the first date a problem was suspected and continue
through the most recent activity described in the current report.
04/01/95
Chlorinated compounds detected by Withers & Ravenel (W&R) during removal and closure of Underground Storage
Tanks.
05/01/95
W&R complete preliminary investigation, install one monitoring well at the site.
08/08/95
W&R conduct Phase II Investigation, install eight monitoring wells as the site.
02/01/96
W&R complete Phase III Investigation, excavating a total of 400 cubic yards of contaminated soil.
12/06/07
ECS Carolinas, LLP conduct groundwater assessment.
07/10/08
W&R sampled existing wells and prepared Prioritization Assessment Report.
10/22/08
W&R installed five off -site monitoring wells on neighboring Olin T. Binkley Church property. Report on this date
documents these activities.
02/17/09
W&R authorized to conduct aggressive fluid vapor recovery event. Report on this date documents these activities and
result of post AFVR groundwater monitoring. Site placed in quarterly monitoring by DSCA program.
04/17/09
Second AFVR event authorized and post event groundwater monitoring documented in report issued on this date.
08/04/09
Groundwater monitoring report submitted to DSCA.
11/11/09
Third AFVR event authorized and post event groundwater monitoring documented in report issued on this date.
02/19/09
Groundwater monitoring report submitted to DSCA.
04/15/10
Fourth AFVR event authorized and post event groundwater monitoring documented in report issued on this date.
05/27/10
Outdoor air, indoor air and sub slab vapor sampling on church property documented in report issued on this date.
08/17/10
First semi-annual indoor air monitoring event at church documented in report issued on this date.
09/14/10
Groundwater monitoring report submitted to DSCA.
12/01/10
Fifth AFVR event authorized and post event groundwater monitoring documented in report issued on this date.
02/21/11
Groundwater monitoring report submitted to DSCA.
02/23/11
Second semi-annual indoor air monitoring event at church documented in report issued on this date.
03/08/11
Soil vapor sampling report for Harris Teeter property to the west.
06/09/11
W&R completes underground injection control permit application to inject Adventus product EHC, and receives UIC
permit to conduct pilot test.
06/13/11
Groundwater monitoring report submitted to DSCA.
06/30/11
Indoor air sampling at Harris Teeter documented in report issued on this date.
O1/07/12
Draft injection pilot test (three month post injection) issued on this date.
11/07/12
One-year post injection pilot test report issued on this date.
04/15/13
W&R conducts hydrogeological study to find permeable saturated zone for injection on church property. Bedrock was
encountered above the surficial water table at most geoprobe drilling locations, which would preclude use of geoprobe to
do injection. Report issued on this date documents the study and findings.
09/24/13
End of W&R involvement in project due to expiration of contract.
11/12/13
Groundwater Sampling Event, conducted by AECOM.
12/6/13 - 12/13/13
Indoor/Outdoor Air Sampling Event, Conducted by AECOM.
Page 1 of 2

Table 1: Site Chronology
DSCA ID No.: DC680002
Chronology of Events
Date
Instructions: Brief description of all significant events that have occurred since a problem was
suspected at the facility. Commence with the first date a problem was suspected and continue
through the most recent activity described in the current report.
02/07/14
Groundwater Sampling Event, conducted by AECOM.
06/27/14
Installation of 4 groundwater monitoring wells 2W-9, 2W-10, 2W-11, and 2W-12
07/08/14
Groundwater Sampling Event, conducted by AECOM.
08/22/14
Soil gas sampling event, conducted by AECOM
03/19/15
Indoor Air Sampling Event, conducted by AECOM
06/17/15
Indoor Air Sampling Event, conducted by AECOM
1 1/23/15
Groundwater samples collected from wells MW-2, MW-3, 2W-4, 2W-5, 2W-9, 2W-10, 2W-11, and 2W-12.
O1/11/16
Indoor Air Sampling Event, conducted by AECOM
06/06/16
Indoor Air Sampling Event, conducted by AECOM
12/12/16
Indoor Air (IA-2 and IA-3), Soil Vapor (SV-5 and SV-6), and Groundwater Sampling (MW-2, 2W-9, 2W-10, and 2W-
11) Event, conducted by URS. Two new soil vapor points (SV-5 and SV-6) were installed in the playground area of the
Olin T. Binkley Memorial Church.
6/20/17 -
6/28/17
Indoor Air (IA-2 and IA-3) and Soil Vapor (SV-5 and SV-6) sampling event was conducted by AECOM.
12/12/17 -
12/18/17
Indoor Air (IA-2 and IA-3) and Soil Vapor (SV-5 and SV-6) sampling event was conducted by AECOM.
06/08/18 -
06/15/18
Indoor Air (IA-2 and IA-3) and Soil Vapor (SV-5) sampling event was conducted by AECOM. Soil vapor sampling
point SV-6 had moisture in tubing and was not able to be sampled.
12/19/18
A soil vapor (SV-5) and limited groundwater sampling event of four wells (MW-2, 2W-9, 2W-10, and 2W-11) was
conducted by AECOM. Soil vapor sampling point SV-6 had moisture in tubing and was not able to be sampled.
12/14/18 -
12/21/18
Indoor Air (IA-2 and IA-3) and Soil Vapor (SV-5) sampling event was conducted by AECOM.
01/11/19 -
O1/18/19
Confirmatory 7-day indoor air samples (IA-2 and IA-3) were collected via Radiello samplers, and samples (IA-2[8-hr]
and IA-3[8-hr]) were collected via 6-liter summa canisters on January 11, 2019.
'02/08/19 -
02/15/19
Confirmatory 7-day indoor air samples (IA-2 and IA-3) were collected via Radiello samplersby AECOM.
02/14/19
Damaged monitoring well 2W-8 was abandoned by an NC Licensed Drilling contractor.
06/07/19 -
06/14/19
Indoor Air (IA-2 and IA-3) and Soil Vapor (SV-5 and SV-6r) sampling event was conducted by AECOM.
Page 2 of 2

Table 4: Analytical Data for Soil Gas
DSCA ID No.: DC680002
N
0
'
y
U
N
N
A
N
O
O
N
A
i
O
iL
p
iL
iL
Q�
U
W
O N
Q
In/m3]
SV-1
4
0.5h
03/01/11
NA
31.3
NA
NA
NA
361
NA
<1.3
147
13.8
NA
NA
SV-2
4
0.5h
03/01/11
NA
<1.5
NA
NA
NA
<2.5
NA
<1.5
<2.0
<0.94
NA
NA
SV-3
4
0.5h
03/01/11
NA
<1.4
NA
NA
NA
16.9
NA
<1.4
1.8
<0.87
NA
NA
SV-4
3
0.5h
03/01/11
NA
1.6
NA
NA
NA
<1.4
NA
10.1
5.5
<0.87
NA
NA
7
0.5h
12/12/16
NA
16,000
NA
NA
NA
150,000
NA
410
35,000
1 <5.1
NA
NA
7
0.5 h
06/28/17
NA
9,740
NA
NA
NA
75,800
NA
347
24,900
<10.2
NA
NA
S V-5
7
0.5 h
12/12/17
NA
11,000
NA
NA
NA
86,000
NA
260
23,000
<5.1
NA
NA
7
0.5 h
06/15/18
NA
18,000
NA
NA
NA
140,000
NA
480
40,000
<51
NA
NA
7
0.5 h
12/19/18
NA
9,800
NA
NA
NA
120,000
NA
390
24,000
<38
NA
NA
7
0.5 h
06/14/19
NA
6,000
NA
NA
NA
93,000
NA
320
18,000
<38
NA
NA
7
0.5h
12/12/16
NA
880
NA
NA
NA
31,000
NA
190
4,800
<5.1
NA
NA
SV-6
7
0.5 h
06/28/17
NA
262
NA
NA
NA
3,850
NA
154
484
<1.02
NA
NA
7
0.5 h
12/12/17
NA
830
NA
NA
NA
21,000
NA
98
3,300
<5.1
NA
NA
SV-6r
7
0.5 h
06/14/19
NA
81
NA
NA
NA
13,000
NA
66
1,300
<5.1
NA
NA
SGOI
3.33
0.5h
07/09/14
NA
19
NA
NA
NA
330
NA
<1.2
110
<0.77
NA
<1.2
SG02
3.33
0.5h
07/09/14
NA
180
NA
NA
NA
130,000
NA
<140
920
<90
NA
<140
SG03
3.33
0.5h
07/09/14
NA
<22
NA
NA
NA
11,000
NA
1 <22
70
1 <14
NA
<22
Indicate "G" for grab sample or for
longer samples indicate the number of hours followed
by "h".
Page 1 of I

Table 5: Analytical Data for Indoor and Outdoor Air
DSCA ID No.: DC680002
r
O
3
05/04/10
AD
SU
8h
ND
ND
ND
ND
NA
9.3
7.3
ND
ND
ND
ND
IA-1
07/22/10
AD
P
7d
NA
ND
NA
NA
NA
14
NA
ND
0.93
ND
NA
01/28/11
AD
P
7d
NA
0.13
NA
NA
NA
6.1
NA
ND
6.6
ND
NA
05/04/10
AD
SU
8h
ND
ND
ND
ND
NA
7.4
7.4
ND
10.8
ND
ND
08/23/11
AD
P
34d
NA
0.14
NA
NA
NA
10.0
NA
ND
1.0
ND
NA
08/30/11
AD
P
7d
NA
0.33
NA
NA
NA
11.0
NA
ND
1.3
ND
NA
09/22/11
AD
P
23d
NA
0.13
NA
NA
NA
9.2
NA
ND
0.96
ND
NA
11/18/11
AD
P
30d
NA
0.075
NA
NA
NA
5.2
NA
ND
0.58
ND
NA
11/30/11
AD
P
13d
NA
ND
NA
NA
NA
3.6
NA
ND
0.45
ND
NA
03/01/12
AD
P
10d
NA
ND
NA
NA
NA
3.5
NA
ND
0.41
ND
NA
06/01/12
AD
P
8d
NA
ND
NA
NA
NA
5.1
NA
ND
0.48
ND
NA
09/04/12
AD
P
5d
NA
0.24
NA
NA
NA
10.0
NA
ND
1.30
ND
NA
12/13/13
AD
P
7d
NA
0.18
NA
NA
NA
4.9
NA
ND
0.56
ND
NA
03/19/15
AD
P
7d
NA
<0.32
NA
NA
NA
1.9
NA
<0.33
0.22
<0.44
NA
IA-2
06/17/15
AD
P
7d
NA
<0.32
NA
NA
NA
4
NA
<0.33
0.47
<0.44
NA
01/11/16
AD
P
8d
NA
<0.28
NA
NA
NA
2.4
NA
<0.29
0.23
<0.28
NA
06/13/16
AD
P
7d
NA
<0.32
NA
NA
NA
3.9
NA
<0.33
0.39
<0.44
NA
12/12/16
AD
P
7d
NA
<0.32
NA
NA
NA
4.0
NA
<0.34
0.46
<0.45
NA
06/20/17
AD
P
7d
NA
<0.28
NA
NA
NA
3.1
NA
<0.29
0.35
<0.39
NA
12/18/17
AD
P
7d
NA
<0.32
NA
NA
NA
4.3
NA
<0.33
0.59
<0.44
NA
06/15/18
AD
P
7d
NA
<0.24
NA
NA
NA
2.8
NA
<1.2
<0.29
<0.15
NA
12/21/18
AD
P
7d
NA
<0.24
NA
NA
NA
4.6
NA
<1.2
1.9
<0.15
NA
01/11/19
AD
SU
8h
NA
<0.14
NA
NA
NA
1.4
NA
<0.14
0.15J
<0.09
NA
01/18/19
AD
P
7d
NA
<0.24
NA
NA
NA
2.6
NA
<1.2
1.6
<0.15
NA
02/15/19
AD
P
7d
NA
<0.24
NA
NA
NA
2.5
NA
<1.2
1.6
<0.15
NA
06/14/19
AD
P
7d
NA
<0.24
NA
NA
NA
29
NA
<1.2
1
<0.15
NA
05/04/10
AD
SU
8h
9.5
ND
3.0
ND
NA
4.6
22.6
ND
8.8
ND
18.7
07/22/10
AD
P
7d
NA
ND
NA
NA
NA
12
NA
ND
0.75
ND
NA
01/28/11
AD
P
7d
NA
0.15
NA
NA
NA
7.1
NA
ND
0.8
ND
NA
08/23/11
AD
P
34d
NA
0.14
NA
NA
NA
9.8
NA
ND
0.99
ND
NA
08/30/11
AD
P
7d
NA
0.31
NA
NA
NA
12.0
NA
ND
1.20
ND
NA
09/22/11
AD
P
23d
NA
0.11
NA
NA
NA
8.1
NA
ND
0.88
ND
NA
11/18/11
AD
P
30d
NA
0.093
NA
NA
NA
6.2
NA
ND
0.75
ND
NA
11/30/11
AD
P
13d
NA
ND
NA
NA
NA
4.1
NA
ND
0.51
ND
NA
03/01/12
AD
P
10d
NA
ND
NA
NA
NA
3.8
NA
ND
0.44
ND
NA
06/01/12
AD
P
8d
NA
ND
NA
NA
NA
5.5
NA
ND
0.50
ND
NA
09/04/12
AD
P
5d
NA
0.28
NA
NA
NA
12.0
NA
ND
1.50
ND
NA
12/13/13
AD
P
7d
NA
0.19
NA
NA
NA
5.9
NA
ND
0.68
ND
NA
IA-3
03/19/15
AD
P
7d
NA
<0.32
NA
NA
NA
1.8
NA
<0.33
0.21
<0.44
NA
06/17/15
AD
P
7d
NA
<0.32
NA
NA
NA
4.4
NA
<0.33
1 0.5
<0.44
NA
01/11/16
AD
P
8d
NA
<0.28
NA
NA
NA
2.4
NA
<0.29
0.24
<0.39
NA
06/13/16
AD
P
7d
NA
<0.32
NA
NA
NA
3.4
NA
<0.33
0.36
<0.44
NA
12/12/16
AD
P
7d
NA
<0.32
NA
NA
NA
3.2
NA
<0.34
0.34
<0.45
NA
06/20/17
AD
P
7d
NA
<0.28
NA
NA
NA
3.2
NA
<0.29
0.38
<0.39
NA
12/18/17
AD
P
7d
NA
<0.32
NA
NA
NA
4.5
NA
<0.33
0.59
<0.44
NA
06/15/18
AD
P
7d
NA
<0.24
NA
NA
NA
2.9
NA
<1.2
<0.29
<0.15
NA
12/21/18
AD
P
7d
NA
<0.24
NA
NA
NA
5.9
NA
1 <1.2
2.1
<0.15
NA
01/11/19
AD
SU
8-h
NA
<0.16
NA
NA
NA
1.4
NA
<0.16
0.12J
<0.01
NA
01/18/19
AD
P
7d
NA
<0.24
NA
NA
NA
2.3
NA
<1.2
1.4
<0.15
NA
02/15/19
AD
P
7d
NA
<024
NA
NA
NA
1.8
NA
<1.2
1.6
<0.15
NA
06/14/19
AD
P
7d
NA
<0.24
NA
NA
NA
32
NA
<1.2
1 <0.29
<0.15
NA
IA4
05/04/10
AD
SU
Sh
0.8
ND
ND
ND
NA
3.9
4.7
ND
ND
ND
ND
IA-5
05/04/10
AD
SU
8h
ND
ND
ND
ND
NA
ND
1.5
ND
ND
ND
ND
07/22/10
AD
P
7d
NA
ND
NA
NA
NA
5.1
NA
ND
0.45
ND
NA
06/15/11
AD
SU
8h
NA
3.9
NA
NA
NA
4.1
NA
ND
0.18
ND
NA
IA-6
01/10/12
AD
SU
8h
NA
2.4
NA
NA
NA
1.6
NA
ND
0.23
ND
NA
HT-IA-1
03/19/15
AD
P
7d
NA
<0.32
NA
NA
NA
0.88
NA
10 C
<0.14
<0.44
NA
HT-IA-2
03/19/15
AD
P
7d
NA
<0.32
NA
NA
NA
3.8
NA
9.0 C
<0.14
1 <0.44
NA
BG-1
05/04/10
AD
SU
Sh
ND
ND
ND
0.98
NA
ND
1.5
ND
ND
ND
ND
BG-2
05/04/10
AD
SU
Sh
ND
ND
ND
ND
NA
ND
ND
ND
1.8
ND
ND
OAA-1
12/13/13
AD
P
7d
NA
ND
NA
NA
NA
ND
NA
ND
ND
ND
NA
Notes:
Page 1 of4

Table 5(2): Additional Data for Indoor and Outdoor Air
CA ID No.: DC680002
Is dry-cleaning facility at the site: Operating ❑ Pick-up Only ❑ Abandoned ❑'
If facility is operating, solvents used are: Perc ❑ Petroleum ❑ Green Earth ❑ Other ❑
For the active or former dry-cleaning space, describe the type and location of the air handling/HVAC unit (for example - a shared unit supplying two adjacent spaces; unit located on the root):
- The air handling/HVAC unit(s) are located on the roof of the Harris Teeter building.
For any indoor air spaces tested, describe the current use of the space
(for example - an ABC liquor store adjacent to the dry-cleaner, a residence approximately 200 feet from the dry-cleaner, etc.):
Harris Teeter (former American Dry -Cleaners).
Olin T. Hinkley Baptist Church preschool facility located 150 feet east (down gradient) of former American Dry Cleaners.
For any other indoor spaces tested, describe the type and location of the air handling/HVAC unit
(for example - a shared unit supplying two adjacent spaces; unit located on the roof):
Olin T. Binkley Baptist Church
- One air handling/HVAC unit is located on the roof of the west wing where the preschool classrooms are located.
- One air handling/HVAC unit is located on the ground along the south wall where the preschool classrooms are located.
- Three air handling/HVAC units are located on the roof of the east wing where the church offices are located.
- One air handling/HVAC unit is located on the ground along the north wall of the east wing where church sactuary is located.
Sampling location map that indicates where all indoor air samples were collected. The map should clearly indicate the names/types of businesses and residence names sampled and in the vicinity of the subject site that maybe
of concern.
Page 3 of 4

Table 5(3): Additional Data for Indoor and Outdoor Air 1
SCA ID No.: DC680002
Sample ID
Name and Address for Sampling Location
Property Owner Name, Address, and Phone Number
Tenant Name, Address, and Phones Number
IA-2
Olin T. Binkley Baptist Church
Olin T. Binkley Baptist Church
1712 Willow Drive, Chapel Hill, NC 27514
1712 Willow Drive, Chapel Hill, NC 27514
919-9424964(office)
Dale Osborne (Pastor)
919-923-3874 (cell)
IA 3
HT-IA-1
Frank Rinaldo
Harris Teeter, 2110 S Estes Drive, Chapel Hill,
NC 27514
Madison University Mall LLC
2001 Pennsylvania Ave, NW Washington DC 20005
Jeff Hoffinan (Store Manager)
919-933-5700 (Work)
HT-IA-1
[phone]
Page 4 of 4

ATTACHMENT 14
INDOOR AIR / SOIL GAS ANALYTICAL RESULTS MAP

LEGEND
Soil Gas Sample
• Indoor/Ambient Air Sample
0 Site Location
PCE - Tetrachloroethene
TCE - Trichloroethene
cis-1,2-DCE - cis-1,2-Dichloroethene
trans-1,2-DCE - trans-1,2-Dichloroethene
ug/m3 micrograms per cubic meter
J Estimated Concentration
Sample does not exceed acceptable
00 non-residential or residential risk.
Sample exceeds acceptable residential risk
• • based on the DSCA Groundwater to
Indoor Air Resident Risk Calculator.
Sample exceeds acceptable non-residential
00 risk based on the DSCA Groundwater to
Indoor Air Non -Residential Risk
Calculator.
HARRIS TEETER
-CENTER
0 R
AM F IC� RY
R 'LEA
WILLOW DRIVE
SV-6 (6/28/17) 00
PCE - 3,850 ug/m3
TCE - 484 ug/m3
cis-1,2-DCE - 262 ug/m3
trans-1,2-DCE - 154 ug/m3
SV-6 (12/12/17) • •
PCE - 21,000 ug/m3
TCE - 3,300 ug/m3
cis-1,2-DCE - 830 ug/m3
trans-1,2-DCE - 98 ug/m3
SV-6 (6/15/18)
Not Sampled
SV-6 (12/19/18)
Not Sampled
SV-6R (6/14/19) • •
PCE - 13,000 ug/m3
TCE - 1,300 ug/m3
cis-1,2-DCE - 81 ug/m3
trans-1,2-DCE - 66 ug/m3
SV-5 (6/28/17) • •
-,�
PCE - 75,800 ug/m3
TCE - 24,900 ug/m3
cis-1,2-DCE - 9,740 ug/m3
I�4•
f
trans-1,2-DCE - 347 ug/m3
SV-5 (12/12/17) e e
PCE - 86,000 ug/m3
TCE - 23,000 ug/m3
cis-1,2-DCE - 11,000 ug/m3
trans-1,2-DCE - 260 ug/m3
SV-5 (6/15/18) 00
PCE - 140,000 ug/m3
TCE - 40,000 ug/m3
cis-1,2-DCE - 18,000 ug/m3
trans-1,2-DCE - 480 ug/m3
SV-5 (12/19/18) 00
PCE - 120,000 ug/m3
TCE - 24,000 ug/m3
cis-1,2-DCE - 9,800 ug/m3
trans-1,2-DCE - 390 ug/m3
SV-5 (6/14/19) 00
PCE - 93,000 ug/m3
+
TCE - 18,000 ug/m3
cis-1,2-DCE - 6,000 ug/m3
trans-1,2-DCE - 320 ug/m3
l
IA-3 (6/12/17 - 6/20/17)
• •
PCE - 3.2 ug/m3
TCE - 0.38 ug/m3
IA-3 (12/11/17-12/18/17)
0 O
PCE - 4.5 ug/m3
TCE - 0.59 ug/m3
s IA-3 (6/8/18 - 6/15/18)
00
r PCE - 2.9 ug/m3
IA-3 (12/14/18-12/21/18)
00
PCE - 5.9 ug/m3
TCE - 2.1 ug/m3
IA-3 (8-hr) (1/11/19)
00
PCE - 1.4 ug/m3
TCE - 0.12 J ug/m3
IA-3 (1/11/19-1/18/19)
00
PCE - 2.3 ug/m3
TCE - 1.4 ug/m3
IA-3 (2/8/19 - 2/15/19)
00
PCE - 1.8 ug/m3
' TCE - 1.6 ug/m3
IA-3 (6/7/19 - 6/14/19)
00
y 'a PCE - 32 ug/m3
OLIN T.
BAPTIST
IA-2 (6/12/17 - 6/20/17) • •
-
PCE - 3.1 ug/m3
TCE - 0.35 ug/m3
IA-2 (12/11/17-12/18/17) • •
PCE - 4.3 ug/m3
TCE - 0.59 ug/m3
IA-2 (6/8/18 - 6/15/18) 00
PCE - 2.8 ug/m3
IA-2 (12/14/18-12/21/18) 00
PCE - 4.6 ug/m3
TCE - 1.9 ug/m3
IA-2 (8-hr) (1/11/19) 00
PCE - 1.4 ug/m3
TCE - 0.15 J ug/m3
IA-2 (1/11/19-1/18/19) 00
PCE - 2.6 ug/m3
TCE - 1.6 ug/m3
IA-2 (2/8/19 - 2/15/19) • •
PCE - 2.5 ug/m3
TCE - 1.6 ug/m3
IA-2 (6/7/19 - 6/14/19) • 4D
PCE - 29 ug/m3
TCE - 1.0 ug/m3
j
0 100
Feet
Indoor Air/Soil Gas Results Map
AECOM TECHNICAL SERVICES
5925CARNEOIE BOULEVARD, SUITE 370
COM OFNORTHCAEB20UE INC
��
American Dry Cleaners
N
N
28209
201 South Estes Drive
x
°'
J64�CHARLOTTE,NC
TEL: [phone]
yam,
b A
FAX: [phone]
Chapel Hill, NC
w
10
SHEET:
S
DSCA Site # DC680002
Attachment
14

ATTACHMENT 15
LABORATORY ANALYTICAL REPORT

icon-tes w .
ANALYTICAL LABORATORY
39 Spruce Street ` East Longmeadow, MA 01028 ` FAX [phone] " TEL. [phone]
June 28, 2019
Nick Shore
AECOM-Morrisville NC
1600 Perimeter Park Drive
Morrisville, NC 27560
Project Location: American Cleaners
Client Job Number:
Project Number: 60600676
Laboratory Work Order Number: 19F1004
Enclosed are results of analyses for samples received by the laboratory on June 17, 2019. If you have any questions concerning
this report, please feel free to contact me.
Sincerely,
I,&, �. A��
Kerry K. McGee
Project Manager
QA Officer
Katherine Allen
Laboratory Manager
Daren Damboragian
Page 1 of 18

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ANALYTICAL LABORATORY
39 Spruce Street ` East Longmeadow, MA 01028 ` FAX [phone] " TEL. [phone]
AECOM-Morrisville NC REPORT DATE: 6/28/2019
1600 Perimeter Park Drive
Morrisville, NC 27560 PURCHASE ORDER NUMBER: 60600676
ATTN: Nick Shore
PROJECT NUMBER: 60600676
ANALYTICAL SUMMARY
WORK ORDER NUMBER: 19F1004
The results of analyses performed on the following samples submitted to the CON -TEST Analytical Laboratory are found in this report.
PROJECT LOCATION: American Cleaners
FIELD SAMPLE # LAB ID: MATRIX SAMPLE DESCRIPTION TEST SUB LAB
SV-5
19F1004-01
Soil Gas
EPATO-15
SV-6r
19171004-02
Soil Gas
EPATO-15
IA-2 (610 HL)
19171004-03
Air
RAD 130
IA-3 (611 HL)
19F1004-04
Air
RAD 130
Page 2 of 18

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ANALYTICAL LABORATORY
39 Spruce Street ` East Longmeadow, MA 01028 ` FAX [phone] " TEL. [phone]
CASE NARRATIVE SUMMARY
All reported results are within defined laboratory quality control objectives unless listed below or otherwise qualified in this report.
REVISED REPORT - 6/28/2019 - Sample i.d. edited for sample 19F1004-02 per client's request.
For method Radiello RAD-130 - The sampling rates for trichloroethene and tetrachloroethene are as follows: trichloroethene = 69 mL/min,
tetrachloroethene = 59 mL/min. The theoretical sampling rates for vinyl chloride, trans-1,2-dichloroethene, and cis-1,2-dichloroethene are estimated
using Graham's Law and are as follows: vinyl chloride = 103 mL/min, trans-1,2-dichloroethene = 83 mL/min, cis-1,2-dichloroethene = 83 mL/min. The
results for these 3 compounds are estimated values.
EPA TO-15
Qualifications
Elevated reporting limit due to high concentration of target compounds.
Analyte & Samples(s) Qualified:
19F1004-01[SV--5], 19F1004-02[SV-6r]
The results of analyses reported only relate to samples submitted to the Con -Test Analytical Laboratory for testing.
I certify that the analyses listed above, unless specifically listed as subcontracted, if any, were performed under my direction according to the approved methodologies listed
in this document, and that based upon my inquiry of those individuals immediately responsible for obtaining the information, the material contained in this report is, to the
best of my knowledge and belief, accurate and complete.
t&� L�. ALUtt
Kerry K. McGee
Project Manager
Page 3 of 18

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ANALYTICAL LABORATORY
39 Spruce Street ` East Longmeadow, MA 01028 ` FAX [phone] " TEL. [phone]
ANALYTICAL RESULTS
Project Location: American Cleaners
Sample Description/Location:
Date Received: 6/17/2019
Sub Description/Location:
Field Sample #: SV-5
Canister ID: 2004
Sample ID: 19F1004-01
Canister Size: 6 liter
Sample Matrix: Soil Gas
Flow Controller ID: 4367
Sampled: 6/14/2019 14:00
Sample Type: 30 min
Work Order: 19171004
Initial Vacuum(in Hg): -30
Final Vacuum(in Hg): -5
Receipt Vacuum(in Hg): -5.3
Flow Controller Type: Fixed -Orifice
Flow Controller Calibration
RPD Pre and Post -Sampling:
EPA TO-15
Sample Flags: RL-11
ppbv
ug/m3
Date/Time
Analyte
Results
RL
MDL
Flag/Qual Results
RL
MDL
Dilution
Analyzed
Analyst
cis-1,2-Dichloroethylene
1500
15
6.1
6000
59
24
300
6/21/19 22:16
BRF
trans-1,2-Dichloroethylene
80
15
6.1
320
59
24
300
6/21/19 22:16
BRF
Tetrachloroethylene
14000
15
8.3
93000
100
57
300
6/21/19 22:16
BRF
Trichloroethylene
3300
15
6.1
18000
81
33
300
6/21/19 22:16
BRF
Vinyl Chloride
ND
15
9.4
ND
38
24
300
6/21/19 22:16
BRF
Surrogates
4-Bromofluorobenzene (1)
% Recovery
99.0
% REC Limits
70-130
6/21/19 22:16
Page 4 of 18

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ANALYTICAL LABORATORY
39 Spruce Street ` East Longmeadow, MA 01028 ` FAX [phone] " TEL. [phone]
ANALYTICAL RESULTS
Project Location: American Cleaners
Sample Description/Location:
Work Order: 19171004
Date Received: 6/17/2019
Sub Description/Location:
Initial Vacuum(in Hg): -30
Field Sample #: SV-6r
Canister ID: 1909
Final Vacuum(in Hg): -5
Sample ID: 19F1004-02
Canister Size: 6 liter
Receipt Vacuum(in Hg): -4.2
Sample Matrix: Soil Gas
Flow Controller ID: 4368
Flow Controller Type: Fixed -Orifice
Sampled: 6/14/2019 14:50
Sample Type: 30 min
Flow Controller Calibration
RPD Pre and Post -Sampling:
EPA TO-15
Sample Flags: RL-11
ppbv
ug/m3
Date/Time
Analyte
Results
RL
MDL
Flag/Qual Results
RL
MDL
Dilution
Analyzed
Analyst
cis-1,2-Dichloroethylene
20
2.0
0.82
81
7.9
3.2
40
6/21/19 23:45
BRF
trans-1,2-Dichloroethylene
17
2.0
0.81
66
7.9
3.2
40
6/21/19 23:45
BRF
Tetrachloroethylene
1900
2.0
1.1
13000
14
7.5
40
6/21/19 23:45
BRF
Trichloroethylene
250
2.0
0.81
1300
11
4.3
40
6/21/19 23:45
BRF
Vinyl Chloride
ND
2.0
1.3
ND
5.1
3.2
40
6/21/19 23:45
BRF
Surrogates % Recovery % REC Limits
4-Bromofluorobenzene (1) 96.7 70-130 6/21/19 23:45
Page 5 of 18

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ANALYTICAL LABORATORY
39 Spruce Street ` East Longmeadow, MA 01028 ` FAX [phone] " TEL. [phone]
ANALYTICAL RESULTS
Project Location: American Cleaners
Sample Description/Location:
Work Order: 19171004
Date Received: 6/17/2019
Sub Description/Location:
Field Sample #: IA-2 (610 HL)
Sample ID: 19F1004-03
Sample Matrix: Air
Flow Controller ID:
Sampled: 6/14/2019 11:40
Sample Type:
Air Volume L: 10115
RAD 130
Total µg
ug/m3
Date/Time
Analyte
Results
RL MDL Flag/Qual
Results
RL MDL
Dilution
Analyzed
Analyst
Vinyl Chloride
ND
0.16
ND
0.15
1
6/24/19 15:35
IMR
trans-1,2-Dichloroethene
ND
1.0
ND
1.2
1
6/24/19 15:35
IMR
cis-1,2-Dichloroethene
ND
0.20
ND
0.24
1
6/24/19 15:35
IMR
Tichloroethene
0.71
0.20
1.0
0.29
1
6/24/19 15:35
IMR
Tetrachloroethene
17
0.20
29
0.34
1
6/24/19 15:35
IMR
Page 6 of 18

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ANALYTICAL LABORATORY
39 Spruce Street ` East Longmeadow, MA 01028 ` FAX [phone] " TEL. [phone]
ANALYTICAL RESULTS
Project Location: American Cleaners
Sample Description/Location:
Work Order: 19171004
Date Received: 6/17/2019
Sub Description/Location:
Field Sample #: IA-3 (611 HL)
Sample ID: 19F1004-04
Sample Matrix: Air
Flow Controller ID:
Sampled: 6/14/2019 11:45
Sample Type:
Air Volume L: 10095
RAD 130
Total µg
ug/m3
Date/Time
Analyte
Results
RL MDL Flag/Qual
Results
RL MDL
Dilution
Analyzed
Analyst
Vinyl Chloride
ND
0.16
ND
0.15
1
6/24/19 15:59
IMR
trans-1,2-Dichloroethene
ND
1.0
ND
1.2
1
6/24/19 15:59
IMR
cis-1,2-Dichloroethene
ND
0.20
ND
0.24
1
6/24/19 15:59
IMR
Tichloroethene
ND
0.20
ND
0.29
1
6/24/19 15:59
IMR
Tetrachloroethene
19
0.20
32
0.34
1
6/24/19 15:59
IMR
Page 7 of 18

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ANALYTICAL LABORATORY
39 Spruce Street ` East Longmeadow, MA 01028 ` FAX [phone] " TEL. [phone]
Sample Extraction Data
Prep Method: TO-15 Prep -EPA TO-15
Pre-Dil Pre-Dil
Default
Actual
Pressure Pre Initial Final
Injection
Injection
Lab Number [Field ID]
Batch
Dilution Dilution mL mL
mL
mL Date
19F1004-01 [SV-51
B234143
1.5 200 5 1000
400
400 06/21/19
19F1004-02 [SV-6r]
B234143
1.5 1 N/A 1000
400
15 06/21/19
Prep Method: Radiello-RAD 130
Lab Number [Field ID]
Batch
Initial [Cartridge Final [mL]
Date
19F1004-03 [IA-2 (610 HL)]
B233916
1.00 2.00
06/21/19
19F1004-04 [IA-3 (611 HL)]
B233916
1.00 2.00
06/21/19
Page 8 of 18

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ANALYTICAL LABORATORY
39 Spruce Street ` East Longmeadow, MA 01028 ` FAX [phone] " TEL. [phone]
QUALITY CONTROL
Miscellaneous Air Analyses - Quality Control
Total µg ug/m3 Spike Level Source %REC RPD
nalyte Results RL Results RL Total µg Result %REC Limits RPD Limit Flag/Qua
Batch B233916 - Radiello
Blank (B233916-BLKI)
Prepared: 06/21/19 Analyzed: 06/24/19
Vinyl Chloride
ND
0.16
trans-1,2-Dichloroethene
ND
1.0
cis-1,2-Dichloroethene
ND
0.20
Trichloroethene
ND
0.20
Tetrachloroethene
ND
0.20
LCS (B233916-BS1)
Prepared: 06/21/19 Analyzed: 06/24/19
Vinyl Chloride
6.21
0.16
0.41 10.0 62.1
40-140
trans-1,2-Dichloroethene
7.84
1.0
10.0 78.4
40-140
cis-1,2-Dichloroethene
7.96
0.20
10.0 79.6
40-140
Trichloroethene
7.57
0.20
10.0 75.7
40-140
Tetrachloroethene
7.26
0.20
10.0 72.6
40-140
LCS Dup (B233916-BSD1)
Prepared: 06/21/19 Analyzed: 06/24/19
Vinyl Chloride
7.30
0.16
0.41 10.0 73.0
40-140
16.1
30
trans-1,2-Dichloroethene
8.64
1.0
10.0 86.4
40-140
9.71
30
cis-1,2-Dichloroethene
9.35
0.20
10.0 93.5
40-140
16.0
30
Trichloroethene
8.93
0.20
10.0 89.3
40-140
16.5
30
Tetrachloroethene
8.84
0.20
10.0 88.4
40-140
19.6
30
Page 9 of 18

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ANALYTICAL LABORATORY
39 Spruce Street ` East Longmeadow, MA 01028 ` FAX [phone] " TEL. [phone]
QUALITY CONTROL
Air Toxics by EPA Compendium Methods - Quality Control
ppbv ug/m3 Spike Level Source %REC RPD
Analyte Results RL Results RL ppbv Result %REC Limits RPD Limit Flag/Qual
Batch B234143 - TO-15 Prep
Blank (B234143-BLKI)
Prepared & Analyzed: 06/21/19
cis-1,2-Dichloroethylene
ND
0.035
trans-1,2-Dichloroethylene
ND
0.035
Tetrachloroethylene
ND
0.035
Trichloroethylene
ND
0.035
Vinyl Chloride
ND
0.035
Surrogate: 4-Bromofluorobenzene (1)
LCS (B234143-BSI)
7.74
8.00 96.8
Prepared & Analyzed: 06/21/19
70-130
cis-1,2-Dichloroethylene
3.71
5.00 74.2
70-130
trans-1,2-Dichloroethylene
4.36
5.00 87.2
70-130
Tetrachloroethylene
4.03
5.00 80.6
70-130
Trichloroethylene
3.96
5.00 79.1
70-130
Vinyl Chloride
3.96
5.00 79.2
70-130
Surrogate: 4-Bromofluorobenzene (1) 8.10 8.00 101 70-130
Page 10 of 18

icon-tes w .
ANALYTICAL LABORATORY
39 Spruce Street ` East Longmeadow, MA 01028 * FAX [phone] " TEL. [phone]
FLAG/QUALIFIER SUMMARY
*
QC result is outside of established limits.
t
Wide recovery limits established for difficult compound.
$
Wide RPD limits established for difficult compound.
#
Data exceeded client recommended or regulatory level
RL
Reporting Limit
MDL
Method Detection Limit
RPD
Relative Percent Difference
LCS
Laboratory Control Sample
LCS Dup
Duplicate Laboratory Control Sample
MS
Matrix Spike Sample
MS Dup
Duplicate Matrix Spike Sample
REC
Recovery
QC
Quality Control
ppbv
Parts per billion volume
EPA
United States Environmental Protection Agency
% REC Percent Recovery
ND Not Detected
N/A Not Applicable
DL Detection Limit
NC Not Calculated
LFB/LCS Lab Fortified Blank/Lab Control Sample
ORP Oxidation -Reduction Potential
wet Not dry weight corrected
% wt Percent weight
Kg Kilogram
g Gram
mg Milligram
µg Microgram
ng Nanogram
L Liter
mL Milliliter
µL Microliter
m3 Cubic Meter
EPH Extractable Petroleum Hydrocarbons
VPH Volatile Petroleum Hydrocarbons
APH Air Petroleum Hydrocarbons
FID Flame Ionization Detector
PID Photo Ionization Detector
Percent recoveries and relative percent differences (RPDs) are determined by the software using values in the
calculation which have not been rounded.
RL-11 Elevated reporting limit due to high concentration of target compounds.
ANALYST
TPH
Thomas P. Hnitecki
RAP
RaisaA. Petraitis
PEB
Paula E. Blakeborough
KKM
Kerry K. McGee
IMR
Irina Raducan
CLA
Catherine L. Amrich
CJM
Christian J. Merchant
BRF
Brittany R. Fisk
Page 11 of 18

icon-tes w .
ANALYTICAL LABORATORY
39 Spruce Street ` East Longmeadow, MA 01028 ` FAX [phone] " TEL. [phone]
INTERNAL STANDARD AREAAND RT SUMMARY
EPA TO-15
Internal Standard
Response
RT
Reference
Response
Reference
RT
Area %
Area o/
Limits
RT Diff
RT Diff
Limit
Q
Initial Cal Check (S036903-ICV1) Lab File ID: H1914916.13 Analyzed: 05/30/19 05:00
Bromochloromethane (1)
235809
9.19
250109
9.19
94
60 - 140
0.0000
+/-0.50
1,4-Difluorobenzene(1)
689777
11.092
642900
11.092
107
60-140
0.0000
+/-0.50
Chlorobenzene-d5(1)
629422
15.877
581108
15.877
108
60-140
0.0000
+/-0.50
INTERNAL STANDARD AREAAND RT SUMMARY
RAD 130
Internal Standard
Response
RT
Reference
Response
Reference
RT
Area %
Area o/
Limits
RT Diff
RT Diff
Limit
Q
LCS (B233916-BS1 Lab File ID: B0624002.13 Analyzed: 06/24/19 14:24
2-Fluorotoluene
8432989
13.31
7516154
13.305
112
50-200
0.0050
+/-0.50
LCS Dup (B233916-BSD1) Lab File ID: B0624003.13 Analyzed: 06/24/19 14:47
2-Fluorotoluene
8363106
13.311
7516154
13.305
111
50-200
0.0060
+/-0.50
Blank (B233916-BLK1) Lab File ID: B0624004.13 Analyzed: 06/24/19 15:11
2-Fluorotoluene
8032183
13.312
7516154
13.305
107
50-200
0.0070
+/-0.50
IA-2 (610 HL) (19171004-03) Lab File ID: B0624005.D Analyzed: 06/24/19 15:35
2-Fluorotoluene
7662341
13.313
7516154
13.305
102
50-200
0.0080
+/-0.50
IA-3 (611 HL) (19F1004-04) Lab File ID: B0624006.13 Analyzed: 06/24/19 15:59
2-Fluorotoluene
7657184
13.315
7516154
13.305
102
50-200
0.0100
+/-0.50
INTERNAL STANDARD AREAAND RT SUMMARY
EPA TO-15
Internal Standard
Response
RT
Reference
Response
Reference
RT
Area %
Area %
Limits
RT Diff
RT Diff
Limit
Q
Calibration Check (S037442-CCVI) Lab File ID: H1917204.13 Analyzed: 06/21/19 11:26
Bromochloromethane (1)
243490
9.19
250109
9.19
97
60 - 140
0.0000
+/-0.50
1,4-Difluorobenzene (1)
622067
11.086
642900
11.092
97
60 - 140
-0.0060
+/-0.50
Chlorobenzene-d5 (1)
556147
15.877
581108
15.877
96
60 - 140
0.0000
+/-0.50
LCS (B234143-BS1 ) Lab File ID: 1-11917205.1) Analyzed: 06/21/19 12:12
Bromochloromethane (1)
248895
9.19
243490
9.19
102
60 - 140
0.0000
+/-0.50
1,4-Difluorobenzene(1)
635796
11.092
622067
11.086
102
60-140
0.0060
+/-0.50
Chlorobenzene-d5(1)
566663
15.877
556147
15.877
102
60-140
0.0000
+/-0.50
Blank (B234143-BLK1) Lab File ID: H1917207.13 Analyzed: 06/21/19 13:53
Bromochloromethane (1)
241533
9.19
243490
9.19
99
60 - 140
0.0000
+/-0.50
1,4-Difluorobenzene (1)
613077
11.085
622067
11.086
99
60 - 140
-0.0010
+/-0.50
Chlorobenzene-d5(1)
544820
15.877
556147
15.877
98
60-140
0.0000
+/-0.50
SV-5 (19F1004-01 ) Lab File ID: H1917215.13 Analyzed: 06/21/19 22:16
Bromochloromethane (1)
249280
9.196
243490
9.19
102
60 - 140
0.0060
+/-0.50
1,4-Difluorobenzene(1)
724102
11.092
622067
11.086
116
60-140
0.0060
+/-0.50
Chlorobenzene-d5(1)
642271
15.877
556147
15.877
115
60-140
0.0000
+/-0.50
Page 12 of 18

icon-tes w .
ANALYTICAL LABORATORY
39 Spruce Street ` East Longmeadow, MA 01028 ` FAX [phone] " TEL. [phone]
INTERNAL STANDARD AREAAND RT SUMMARY
EPA TO-15
Internal Standard
Response
RT
Reference
Response
Reference
RT
Area %
Area %
Limits
RT Diff
RT Diff
Limit
Q
SV-6r (19F1004-02) Lab File ID: H1917217.D Analyzed: 06/21/19 23:45
Bromochloromethane (1)
230854
9.196
243490
9.19
95
60 - 140
0.0060
+/-0.50
1,4-Difluorobenzene(1)
636332
11.092
622067
11.086
102
60-140
0.0060
+/-0.50
Chlorobenzene-d5(1)
560094
15.877
556147
15.877
101
60-140
0.0000
+/-0.50
Page 13 of 18

icon-tes w .
ANALYTICAL LABORATORY
39 Spruce Street' East Longmeadow, MA 01028 ` FAX [phone] " TEL. [phone]
CONTINUING CALIBRATION CHECK
EPA TO-15
S037442-CCV 1
COMPOUND
TYPE
CONC. (ppbv)
RESPONSE FACTOR
% DIFF / DRIFT
STD
CCV
ICAL
CCV
MIN (#)
CCV
LIMIT (#)
cis-1,2-Dichloroethylene
A
5.00
3.77
1.064439
0.8021553
-24.6
30
trans-1,2-Dichloroethylene
A
5.00
4.27
0.9846697
0.8408789
-14.6
30
Tetrachloroethylene
A
5.00
4.09
0.5221659
0.4267332
-18.3
30
Trichloroethylene
A
5.00
4.01
0.3789929
0.3037563
-19.9
30
Vinyl Chloride
A
5.00
4.22
0.6859689
0.5789807
-15.6
30
# Column to be used to flag Response Factor and %Diff/Drift values with an asterisk
* Values outside of QC limits
Page 14 of 18

icon-tes w .
ANALYTICAL LABORATORY
39 Spruce Street ` East Longmeadow, MA 01028 ' FAX [phone] " TEL. [phone]
CERTIFICATIONS
Certified Analyses included in this Report
Analyte
Certifications
EPA TO-15 in Air
cis-1,2-Dichloroethylene
AIHA,FL,NY,ME,NH,VA
trans-1,2-Dichloroethylene AIHA,NJ,NY,ME,NH,VA
Tetrachloroethylene
AIHA,FL,NJ,NYM E,NH,VA
Trichloroethylene
AIHA,FL,NJ,NY,ME,NH,VA
Vinyl Chloride
AIHA,FL,NJ,NY,ME,NH,VA
The CON -TEST Environmental
Laboratory operates under the following certifications and accreditations:
Code
Description
Number
Expires
AIHA
AIHA-LAP, LLC - ISO17025:2005
100033
03/l/2020
MA
Massachusetts DEP
M-MA100
06/30/2020
CT
Connecticut Department of Publilc Health
PH-0567
09/30/2019
NY
New York State Department of Health
10899 NELAP
04/l/2020
NH-S
New Hampshire Environmental Lab
2516 NELAP
02/5/2020
RI
Rhode Island Department of Health
LA000112
12/30/2019
NC
North Carolina Div. of Water Quality
652
12/31/2019
NJ
New Jersey DEP
MA007 NELAP
06/30/2020
FL
Florida Department of Health
E871027 NELAP
06/30/2020
VT
Vermont Department of Health Lead Laboratory
LL015036
07/30/2020
ME
State of Maine
2011028
06/9/2021
VA
Commonwealth of Virginia
460217
12/14/2019
NH-P
New Hampshire Environmental Lab
2557 NELAP
09/6/2019
VT-DW
Vermont Department of Health Drinking Water
VT-255716
06/12/2020
NC-DW
North Carolina Department of Health
25703
07/31/2019
PA
Commonwealth of Pennsylvania DEP
68-05812
06/30/2020
Page 15 of 18

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Page 16 of 18

Track your package or shipment with FedEx Tracking
77-5491829460`:
Delivered
Wednesday 6/19/2019 at 1.47 pry
DELIVERED
Signed for by- FFOUST
GET STATUS UPDATES
OBTAIN PROOF OF DELIVERY
FROM TO
Raleigh, NC US East Longn Meadlow, IVA US
Shipment Facts
TRACKING NUMBER
SERVICE
REFERENCE
775491229460
I=edEx Ground
80
WEIGHT
DIMENSIONS
TOTAL PIECES
10 lb,; / 4 54 kgs
22x740 in.
1
TERMS
PACKAGING
STANDARD TRANSIT
Third Party
Package
0
6/19/2019
SHIP DATE
ACTUAL DELIVERY
'; ,
wed 6i19/2019 1 47 p11
Mon 6/17/2019
Travel History
Local Scan Time
Wednesday, 6/19/2019
1,47 pm
East Longmeadow, MA
Delivered
4,25 am
CHICOPEE, MA
On FedEx vehicle for delivery
4,24 am
CHICOPEE, MA
At local FedEx facility
1-57 am
MIDDLETOWN, CT
Departed FedEx location
Tuesday, 6/1W2019
Page 17 18
a -AA ,,,„
KAMN PTnW1,1 rr
n.�;.,a� �< r.APF 1�,.a,;�� of
https://www.fedex.comlapps/fedextrack/?action=track&trackingnumber=775491829460&cntry_code=us&locale=en_US 1/2

I Have Not Confirmed Sample Container'
Numbers With Lab Staff Before
Relinquishing Over ^N^L-V-r10^L- L--^OconAa-rr`C)ny
Samples
................
# 2T> . Fieu .G017
Air Media Sample Receipt Checklist - (Rejection Criteria Listing - Using Acceptance Policy) Any False
Statement will be brought to the attention of the Client - State True or False
Client LP t?rn
Received By
Date
How were the samples
In Cooler
received?
In Box —
Were samples within Temperature
13y Gun
Compliance? 2-60C
By Bla
Was Custody Seal Intact?
_
Was COC Relinquished ?
Are there any loose caps/valves on any samples?
Is COC in ink/ Legible?T
DCOC l 1 d 11 Client
- Analy
(, f � • 1q, Time , Q 1
On Ice No Ice
Ambient Melted Ice
# Actual Temp -
nk # Actual Temp -
Were Samples Tampered with?
Does Chain Agree With Samples?
i nc u e a sis -r Sampler Name
Pertinent Information? Project^ ID's� Collection Dates/Times
Are Sample Labels filled out and legible?
Are there Rushes? F Who was notified?
Samples are received within holding time?
Proper Media Used? Individually Certified Cans?
Are there Trip Blanks? Is there enough Volume?
Nut/Ferrule
IC Train
Summa Cans
Tedlar Bags
Tubing
TO-17 Tubes
T-Connector
Radiello
Syringe
PufsITO-11 s
Tedlar
18 of 18

ATTACHMENT 16
DSCA PROGRAM RISK CALCULATORS

DSCA Indoor Air Risk Calculator - Cumulative Risk for Resident
Version 6, November 2017
DSCA ID No:
Name/Address of DSCA Site:
Name/Address of Sampling Location
Sampling Date:
Sample ID:
DC680002
American Dry Cleaners 201 S. Estes Drive, Chapel Hill, Orange County, NC
1712 Willow Drive, Chapel Hill, Orange County, NC
6/14/2019
IA-2
Carcinogenic risk and hazard quotient cells highlighted in orange are associated with non-volatile chemicals. Risks are calculated for these values if indoor air concentrations
are entered and indoor air screening levels have been established, but it should be noted that detections of these chemicals are likely not associated with vapor intrusion.
All concentrations are in u2/tn3
Indoor Air
Indoor Air
Indoor Air
Screening Level
Calculated Non -
CAS #
Chemical Name:
Concentration
Screening Level
for Non-
Calculated
Carcinogenic
3
(ug/m)
for Carcinogens
Carcinogens @
Carcinogenic Risk
Hazard
@ TCR = 1E-06
TH 0.2
= 0.
Quotient
156-59-2
Dichloroethylene, 1,2-cis-
156-60-5
Dichloroeth lene 1 2-trans-
127-18-4
Tetrachloroethylene
29
1.1E+01
8.3E+00
2.7E-06
7.0E-Ol
79-01-6
Trichloroeth lene
1
4.8E-21
4.2E-01
2.1E-06
4.8E-01
75-01-4
Vinyl Chloride
1.7E-Ol
2.1E+O1
Cumulative: I 4.8E-06 I1.2E+00

DSCA Indoor Air Risk Calculator - Cumulative Risk for Resident
Version 6, November 2017
DSCA ID No:
Name/Address of DSCA Site:
Name/Address of Sampling Location
Sampling Date:
Sample ID:
DC680002
American Dry Cleaners 201 S. Estes Drive, Chapel Hill, Orange County, NC
1712 Willow Drive, Chapel Hill, Orange County, NC
6/14/2019
IA-3
Carcinogenic risk and hazard quotient cells highlighted in orange are associated with non-volatile chemicals. Risks are calculated for these values if indoor air concentrations
are entered and indoor air screening levels have been established, but it should be noted that detections of these chemicals are likely not associated with vapor intrusion.
All concentrations are in u2/tn3
Indoor Air
Indoor Air
Indoor Air
Screening Level
Calculated Non -
CAS #
Chemical Name:
Concentration
Screening Level
for Non-
Calculated
Carcinogenic
3
(ug/m)
for Carcinogens
Carcinogens @
Carcinogenic Risk
Hazard
@ TCR = 1E-06
TH 0.2
= 0.
Quotient
156-59-2
Dichloroethylene, 1,2-cis-
156-60-5
Dichloroeth lene 1 2-trans-
127-18-4
Tetrachloroethylene
32
1.1E+01
8.3E+00
3.0E-06
7.7E-Ol
76
Trichloroeth lene
.7E-011
4.2E-019-01-
1-
21E+0175-0
Cumulative: I 3.0E-06 I7.7E-Ol

DSCA Indoor Air Risk Calculator - Cumulative Risk for Non -Residential Worker
Version 6, November 2017
DSCA ID No:
Name/Address of DSCA Site:
Name/Address of Sampling Location
Sampling Date:
Sample ID:
DC680002
American Dry Cleaners 201 S. Estes Drive, Chapel Hill, Orange County, NC
1712 Willow Drive, Chapel Hill, Orange County, NC
6/14/2019
IA-2
Carcinogenic risk and hazard quotient cells highlighted in orange are associated with non-volatile chemicals. Risks are calculated for these values if indoor air concentrations
are entered and indoor air screening levels have been established, but it should be noted that detections of these chemicals are likely not associated with vapor intrusion.
All concentratinns are in ue/m3
Indoor Air
Indoor Air
Indoor Air
Screening Level
Calculated Non -
CAS #
Chemical Name:
Concentration
Screening Level
for Non-
Calculated
Carcinogenic
a
(ug/m)
for Carcinogens
Carcinogens @
Carcinogenic Risk
Hazard
@ TCR=1E-06
THQ = 0.2
Quotient
156-59-2
Dichloroeth lene 1 2-cis-
156-60-5
Dichloroethylene, 1,2-trans-
127-18-4
Tetrachloroeth lene
29
4.7E+01
3.5E+01
6.1E-07
1.7E-01
79-01-6
Trichloroethylene
1
3.0E+00
1.8E+00
3.3E-07
1.1E-01
75-01-4
Vinyl Chloride
2.8E+00
8.8E+01
Cumulative: I 9.5E-07 I2.8E-Ol

DSCA Indoor Air Risk Calculator - Cumulative Risk for Non -Residential Worker
Version 6, November 2017
DSCA ID No:
Name/Address of DSCA Site:
Name/Address of Sampling Location
Sampling Date:
Sample ID:
DC680002
American Dry Cleaners 201 S. Estes Drive, Chapel Hill, Orange County, NC
1712 Willow Drive, Chapel Hill, Orange County, NC
6/14/2019
IA-3
Carcinogenic risk and hazard quotient cells highlighted in orange are associated with non-volatile chemicals. Risks are calculated for these values if indoor air concentrations
are entered and indoor air screening levels have been established, but it should be noted that detections of these chemicals are likely not associated with vapor intrusion.
All concentratinns are in ue/m3
Indoor Air
Indoor Air
Indoor Air
Screening Level
Calculated Non -
CAS #
Chemical Name:
Concentration
Screening Level
for Non-
Calculated
Carcinogenic
a
(ug/m)
for Carcinogens
Carcinogens @
Carcinogenic Risk
Hazard
@ TCR=1E-06
THQ = 0.2
Quotient
156-59-2
Dichloroeth lene 1 2-cis-
156-60-5
Dichloroethylene, 1,2-trans-
127-18-4
Tetrachloroeth lene
32
4.7E+01
3.5E+01
6.8E-07
1.8E-01
79-01-6
Trichloroethylene
3.0E+00
1.8E+00
75-01-4
Vinyl Chloride
2.8E+00
8.8E+01
Cumulative: I 6.8E-07 I1.8E-0 l

DSCA Soil Gas Risk Calculator - Cumulative Risk for Resident
Version 6, November 2017
DSCA ID No: DC680002
Name/Address of DSCA Site: American Dry Cleaners 201 S. Estes Drive, Chapel Hill, Orange County, NC
Name/Address of Sampling Location: 1712 Willow Drive, Chapel Hill, Orange County, NC
Sampling Date: 6/14/2019
Sample ID: SV-5
Carcinogenic risk and hazard quotient cells highlighted in orange are associated with non-volatile chemicals. Since these chemicals do not pose a vapor intrusion risk, no risk
values are calculated for these chemicals.
All cnnnentratinns are in no/m3
Indoor Air
Soil Gas
Calculated Indoor
Indoor Air
Screening Leve]
Calculated Non -
CAS #
Chemical Name:
Concentration
Air Concentration
Screening Level
for Non-
Calculated
Carcinogenic
(ug/m,)
(ug/m)
for Carcinogens @
Carcinogens @
Carcinogenic Risk
Hazard Quotient
TCR = 1E-06
THQ 9 0.2
156-59-2
Dichloroeth lene 1 2-cis-
6000
180
156-60-5
Dichloroethylene, 1,2-trans-
320
9.6
127-18-4
Tetrachloroeth lene
93000
2790
1.1E+01
8.3E+00
2.6E-04
6.7E+01
79-01-6
Trichloroethylene
18000
540
4.8E-01
4.2E-01
l.1E-03
2.6E+02
75-01-4
Vinyl Chloride
1.7E-01
2.1E+01
Cumulative: I 1.4E-03 I 3.3E+02

DSCA Soil Gas Risk Calculator - Cumulative Risk for Resident
Version 6, November 2017
DSCA ID No: DC680002
Name/Address of DSCA Site: American Dry Cleaners 201 S. Estes Drive, Chapel Hill, Orange County, NC
Name/Address of Sampling Location: 1712 Willow Drive, Chapel Hill, Orange County, NC
Sampling Date: 6/14/2019
Sample ID: SV-6r
Carcinogenic risk and hazard quotient cells highlighted in orange are associated with non-volatile chemicals. Since these chemicals do not pose a vapor intrusion risk, no risk
values are calculated for these chemicals.
All cnnnentratinns are in no/m3
Indoor Air
Soil Gas
Calculated Indoor
Indoor Air
Screening Leve]
Calculated Non -
CAS #
Chemical Name:
Concentration
Air Concentration
Screening Level
for Non-
Calculated
Carcinogenic
(ug/m)
(ug/m')
for Carcinogens @
Carcinogens @
Carcinogenic Risk
Hazard Quotient
TCR = 1E-06
THQ = 0.2
156-59-2
Dichloroeth lene 1 2-cis-
81
2.43
156-60-5
Dichloroethylene, 1,2-trans-
66
1.98
127-18-4
Tetrachloroeth lene
13000
390
1.1E+01
8.3E+00
3.6E-05
9.3E+00
79-01-6
Trichloroethylene
1300
39
4.8E-01
4.2E-01
8.2E-OS
1.9E+01
75-01-4
Vinyl Chloride
1.7E-01
2.1E+01
Cumulative: I 1.2E-04 I 2.8E+01

DSCA Soil Gas Risk Calculator - Cumulative Risk for Non -Residential Worker
Version 6, November 2017
DSCA ID No: DC680002
Name/Address of DSCA Site: American Dry Cleaners 201 S. Estes Drive, Chapel Hill, Orange County, NC
Name/Address of Sampling Location: 1712 Willow Drive, Chapel Hill, Orange County, NC
Sampling Date: 6/14/2019
Sample ID: SV-5
Carcinogenic risk and hazard quotient cells highlighted in orange are associated with non-volatile chemicals. Since these chemicals do not pose a vapor intrusion risk, no risk
values are calculated for these chemicals.
All rnn --tinna a in -/ma
Indoor Air
Soil Gas
Calculated Indoor
Indoor Air
Screening Level
Calculated Non -
CAS #
Chemical Name:
Concentration
Air Concentration
Screening Level
for Non
Calculated
Carcinogenic
s
(ug/m)
s
(ug/m)
for Carcinogens @
Carcinogens @
Carcinogenic Risk
Hazard Quotient
TCR= 1E-06
TH = 0.2
156-59-2
Dichloroethylene, 1,2-cis-
6000
60
156-60-5
Dichloroeth lene 1 2-trans-
320
3.2
127-18-4
Tetrachloroethylene
93000
930
4.7E+01
3.5E+O1
2.0E-OS
5.3E+00
79-01-6
Trichloroeth lene
18000
180
3.0E+00
1.8E+00
6.0E-OS
2.1E+01
75-01-4
Vinyl Chloride
I
I 2.8E+00
8.8E+01
Cumulative: I 8.0E-05 I 2.6E+01

DSCA Soil Gas Risk Calculator - Cumulative Risk for Non -Residential Worker
Version 6, November 2017
DSCA ID No: DC680002
Name/Address of DSCA Site: American Dry Cleaners 201 S. Estes Drive, Chapel Hill, Orange County, NC
Name/Address of Sampling Location: 1712 Willow Drive, Chapel Hill, Orange County, NC
Sampling Date: 6/14/2019
Sample ID: SV-6r
Carcinogenic risk and hazard quotient cells highlighted in orange are associated with non-volatile chemicals. Since these chemicals do not pose a vapor intrusion risk, no risk
values are calculated for these chemicals.
All rnn --tinna a in -/ma
Indoor Air
Soil Gas
Calculated Indoor
Indoor Air
Screening Level
Calculated Non -
CAS #
Chemical Name:
Concentration
Air Concentration
Screening Level
for Non
Calculated
Carcinogenic
s
(ug/m)
s
(ug/m)
for Carcinogens @
Carcinogens @
Carcinogenic Risk
Hazard Quotient
TCR= 1E-06
TH = 0.2
156-59-2
Dichloroethylene, 1,2-cis-
81
0.81
156-60-5
Dichloroeth lene 1 2-trans-
66
0.66
127-18-4
Tetrachloroethylene
13000
130
4.7E+O1
3.5E+O1
2.8E-06
7.4E-01
79-01-6
Trichlorceth lene
1300
13
3.0E+00
1.8E+00
4.3E-06
1.5E+00
75-01-4
Vinyl Chloride
2.8E+00
8.8E+01
Cumulative: I 7.1E-06 I 2.2E+00

ATTACHMENT 17
INDOOR AIR SAMPLING BUILDING SURVEY FORM

INDOOR AIR BUILDING SURVEY
and SAMPLING FORM
Site Name: RMt l
Preparer's name:
Preparer's affiliation: Psi—'c1} ,M
Part I - Occupants
DSCAID#:�2000��
Date:
Phone #: S-\45 - y33 U
Building Address: Q L-L—
Property Contact: ►�jPrs l E �-, ti�i�� i . Owner / Renter /n I t 1�]�SS YrICiC�
Contact's Phone: home ( ) work (qtq) "fy Z_ 41j (0 1 cell ( )
# of Building occupants: Children under age 13 ✓ Children age 13-18 Adults ,/
— c1-10RC(A -� ( ',*`RC5C\-r00t_- -- '5-)A'\ vVnq-cz. cAr-,Ps I V\,P-Pl-L- PROF
4 a'ct_t \l4z?- y So cc c,,-) P ('% 1si
Part II — Building Characteristics
Building type: residential / multi -family residential /office strip mall / commercial / industrial
Describe building: 1 6-ropA SPL► —� LfC\3CL— Year constructed: _]gCIM
Sensitive population: ay car / nursing home / hospital schoo / er (speci
Number of floors below grade: (full basement / crawl space / slab on grad )
Number of floors at or above grade: I
Depth of basement below grade surface: ft. Basement size: ft2 1.11 fi
Basement floor construction: concrete / dirt / floating / stone / other (specify):
Foundation walls: poured concrete / inder bloc / stone / other (specify)
Basement sump present? Eau /11In Sump pump? a Water in sump? ter 7`-rr 1,��P \
Type of hea ' ircle all that apply):
air circulat' hot air radiation wood steam radiation
�atum hot water radiation kerosene heater electric baseboard
of(specify): ]�5 N L—q��
Type of ventilat' cle all that apply):
entral air condi ' ing mechanical fans athroom ventilation s
individual air conditioning units kitchen range hood fan outside air in a e
other (specify):
Type of fuel d (circl ll that apply):
aual / fuel oil / wood / coal / solar / kerosene
Are the basement walls or floor sealed with waterproof paint or epoxy coatings? Yes

Is there a whole house fan? Yes I0
Septic system? Yes / Yes (but not used)
Irrigation/private well? Yes / Yes (but not used)
Type of ground cover outside of building: grass oncrete sphalt other (specify)
Existing subsurface depressurization (radon) system in place? Yes No active /passive
Sub -slab vapor/moisture barrier in place? Yes / Co
Type of barrier: Ply-2- yh2 , C �L F3 ec-D6-r HAS
Part III - Outside Contaminant Sources
Other stationary sources nearby (gas stations, emission stacks, etc.):-Q _
Heavy vehicular traffic nearby (or other mobile sources): p,�Q C) j­
Part IV - Indoor Contaminant Sources w L.L_pw Z"�R
Identify all potential indoor sources found in the building (including attached garages), the location of the
source (floor and room), and whether the item was removed from the building 48 hours prior to indoor air
sampling event. Any ventilation implemented after removal of the items should be completed at least 24
hours prior to the commencement of the indoor air sampling event.
Potential Sources
Location(s)
Removed
(Yes / No / NA)
Gasoline storage cans
Gas -powered equipment
Kerosene storage cans
Paints / thinners / strippers
Cleaning solvents
��
Oven cleaners
Carpet / upholstery cleaners
Other house cleaning products
t r M
Moth balls
Polishes / waxes
Insecticides
Furniture / floor polish
Nail polish / polish remover
Hairspray
Cologne / perfume
Air fresheners
Fuel tank (inside building)
NA
Wood stove or fireplace
NA
New furniture / upholstery
New carpeting / flooring
NA
Bobbies - glues, paints, etc.

Part V — Miscellaneous Items
Do any occupants of the building smoke? Yes / No How often?
Last time someone smoked in the building? hours /days ago
Does the building have an attached garage directly connected to living space? Yes / No
If so, is a car usually parked in the garage? Yes / No
Are gas -powered equipment or cans of gasoline/fuels stored in the garage? Yes / No
Do the occupants of the building have their clothes dry cleaned? Q / No
If yes, how often? weekly / monthly / 3-4 times a year
Do any of the occupants use solvents in work? Yes I �o
If yes, what types of solvents are used?
If yes, are their clothes washed at work? Yes / No
Have any pesticides/herbicides been applied around the building or in the yard? Yes 1
If so, when and which chemicals?
Has there ever been a fire in the building? Yes / 6) If yes, when?
Has painting or staining been done in the building in the last 6 months? Yes /(E)
If yes, when and where?
Part VI -- Sampling Information
Sample Technician: �, 'PLC EEF. L_ , - Phone number: (01 ►no S%� - �A33C
Sample Source: ndoor Ai / Crawlspace Air / Sub -Slab / Near Slab Soil Gas xterior Soil G s
Sampler Type: Tedlar bag / Sorbent / tainless Steel Canis er / �(specify),
Analytical Metho 0-)51 0-17 / other: ��' I CD Cert. Laboratory: CQl_
Sample locations (floor, room):
Field ID # _ - _U _ ICField ID # -
Co I I H L
Field ID # Field 1D # -
Were "Instructions for Occupants" followed? es No
If not, describe modifications: Aj! erXjL—N

Provide Drawing of Sample Location(s) in Building
Part VII - Meteorological Conditions
Was there significant precipitation within 12 hours prior to (or during) the sampling event? Yes / No
Describe the general weather conditions: tN Lx) T46 S
wE tt.3yanF S�L4 InIC-11]EE"'Pri --
P���oas ot= 'C>P5�
Part VIII — General Observations
Provide any information that may be pertinent to the sampling event and may assist in the data
interpretation process (e.g., observed that drycleaner operated with door or windows propped open for
ventilation).
(Adapted from the NJDEP Vapor Intrusion Guidance, October 2005)